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Fraser Health Authority
2015/16
ANNUAL SERVICE PLAN REPORT
Fraser Health Authority
2015/16 Annual Service Plan Report 2
For more information on the Fraser Health Authority contact:
Suite 400, Central City Tower
13450 – 102nd
Avenue
Surrey, B.C. V3T 0H1
or, visit our website at
www.fraserhealth.ca
Fraser Health Authority
2015/16 Annual Service Plan Report 3
Board Chair’s Accountability Statement
The Fraser Health Authority 2015/16 Annual Service Plan Report compares
the health authority’s actual results to the expected results identified in the
2015/16–2017/18 Service Plan. The Board is accountable for those results as
reported.
The performance measures presented are consistent with the Ministry of
Health’s mandate and goals, and the focus on aspects critical to the
organization’s performance. The targets had been determined based on an
assessment of the Fraser Health Authority operating environment, forecast
conditions, risk assessment and past performance.
Karen Matty
Board Chair
September 28, 2016
Fraser Health Authority
2015/16 Annual Service Plan Report 4
Table of Contents
Board Chair’s Accountability Statement ................................................................................................ 3
Table of Contents .................................................................................................................................... 4
Chair/CEO Report Letter ........................................................................................................................ 5
Purpose of the Organization .................................................................................................................... 7
Strategic Direction and Context .............................................................................................................. 7
Report on Performance ........................................................................................................................... 9
Goals, Strategies, Measures and Targets .......................................................................................... 10
Financial Report .................................................................................................................................... 20
Discussion of Results ........................................................................................................................ 20
Financial Resource Summary Table ................................................................................................. 21
Major Capital Projects ...................................................................................................................... 22
Appendix A: Health Authority Contact Information ............................................................................ 27
Appendix B: Hyperlinks to Additional Information (optional) ............................................................ 28
Appendix C: Health Authority Mandate and Actions Summary .......................................................... 29
Fraser Health Authority
2015/16 Annual Service Plan Report 5
Chair/CEO Report Letter
The 2014/15 Fraser Health Authority Annual Service Plan Report was prepared under the Board’s
direction in accordance with the Health Authorities Act and the Performance Reporting Principles for
the British Columbia Public Sector. This Annual Report outlines Fraser Health’s performance on
Government expectations as set out in the 2015/16 Ministry of Health Mandate Letter.
This 2015/16 Annual Service Plan Report provides information on our organizational performance
and demonstrates Fraser Health’s commitment of accountability to the people we serve. It sets out
actual performance measures consistent with the Ministry of Health’s mandate and goals, and focuses
on aspects critical to Fraser Health performance. Additional performance indicators are available in
Our Healthcare Report Card which measures and guides improvements at Fraser Health, and each
hospital.
Over the course of the fiscal year, regular engagement between the Ministry of Health and Fraser
Health has helped to guide the organization’s strategic investments and monitor the results. The
Minister of Health, Board Chair, Deputy Minister, CEO along with management and staff at all levels
have established collaborative relationships and worked together to meet the needs of Fraser Health
citizens.
In addition, regular bilateral meetings ensured alignment of multiple functions within and across the
Ministry and Health Authority to stay focused on the Ministry of Health strategic priorities. These
discussions regularly include operations, performance measurement, strategic planning and financial
perspectives.
The Taxpayer Accountability Principles (cost consciousness, accountability, appropriate
compensation, service, respect and integrity) have become a cornerstone for orientation of new Board
members and to regular governance activities for all Board members.
Fraser Health is committed to the mandate of delivering patient-centred services and care and we are
shifting the culture of health care from being disease and provider-focused to being patientt-centred.
Beginning with restructuring the organization in 2014 and creating a new executive responsible for
the patient experience, Fraser Health rebalanced hospital and non-hospital resources. We also
decentralized care management to geographic service areas creating an environment where patients,
families and front line health providers work togethr as partners in providing day-to-day care.
Fraser Health is committed to the mandate of ensuring delivery of high quality and appropriate health
services that best meet the needs of the population in a fiscally sustainable manner. The 2015/16
budget targets were achieved and the year ended in a balanced financial position.
Fraser Health is committed to the mandate of managing performance through continuous
improvement across services and operations. Fraser Health built on successes in increasing
community services that support patients at home, and focused on cultivating a patient-centred culure
across all health care services.
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2015/16 Annual Service Plan Report 6
This past year we remained true to our commitment to provide excellent care to our patients wherever
they are - in our hospitals or at home or in their communities. The following provides highlights of
our actions and progress:
2,000 extra surgeries were performed, above the average 85,000.
Two new client-centred and community-based mental health outreach teams began accepting
clients in Surrey-North Delta and Abbotsford-Mission.
$5 million invested in weekend staffing to improve hospital discharge planning.
$1.9 million invested in Mental Health and Substance Use Initiatives in our communities.
A Declaration of Commitment and Cultural Safety Framework will improve health care access
and outcomes for Indigenous people in our region.
For the fifth year in a row, we were deemed carbon neutral.
Out of our commitment to accountability and transparency, we continued to release monthly Health
Care Report Cards detailing out progress on Key Performance Indicators. Some successes include:
We consistently exceeded our 90% target of hip fractures being repaired within 48 hours of
taking place.
Incidents of facility-associated infections are consistently on the decline.
All of our hospitals have achieved or exceeded our goal for hand hygiene compliance.
Providing quality health care requires dedicated partners. Our work would not be possible without
partnerships with our Foundations, Auxiliaries, community partners and volunteers, as well as the
Fraser Valley Regional Hospital District and Divisions of Family Practice. As proud as we are of this
past year’s successes in our operations, out biggest success is our people.
It’s the enthusiasm and energy of the people who make up this organization that is renewing and
sparking change, shaping the future of a more sustainable, patient-centred and community based
system. We look forward to building on our successes of 2015 to continue to shape a bright future for
the people we serve. It is an exciting time for Fraser Health.
Karen Matty
Board Chair
Michael Marchbank
Chief Executive Officer
Fraser Health Authority
2015/16 Annual Service Plan Report 7
Purpose of the Organization
As one of five regional health authorities in British Columbia, Fraser Health organizes and operates a
system for health and delivers public health, hospital, residential, community-based and primary
health care services. Fraser Health’s legal authority is specified by the Health Authorities Act. Fraser
Health partners with the two non-geographic health authorities (Provincial Health Services Authority
and the First Nations Health Authority) on service delivery that transcends the geographic boundaries
of Fraser Health.
The Ministry of Health (Ministry) appoints nine directors to the Board to govern Fraser Health. Its
governance approach is guided and assessed by Best Practice Guidelines and Governance and
Disclosure Guidelines for Governing Boards of British Columbia Public Sector Organizations. The
Board provides oversight to ensure Fraser Health fulfills its vision and purpose and operates in
accordance with its values. Additional Board accountability and governance practice information is
available at www.fraserhealth.ca/about-us/leadership/board-of-directors.
Central to the vision and mission of Fraser Health is the optimization of the health status of its
residents. Enjoying good health and a high quality of life throughout the course of one’s lifetime is a
consequence of many factors, including access to quality education, meaningful employment,
supportive family and friends, community environments and making healthy lifestyle choices.
Serving this mission are over 26,000 staff members, over 2,500 physicians and 6,500 volunteers
working in partnership in very diverse work settings from hospitals, to mental health centres, public
health units and services in ambulatory clinics and in homes. Fraser Health’s purpose and services are
further detailed at www.fraserhealth.ca.
Availability of performance based information is key to increasing accountability at the hospital,
clinical service, program and organizational levels. In September 2014, Fraser Health began the
regular production and release of Health Care Report Cards which include organization and site based
measures. Since the initial release, awareness and use of the Report Cards have steadily increased at
the hospital, program, public, governance and operational levels. The performance information they
contain is informing decisions and driving improvement in focused areas across the organization. Our
Health Care Report Cards are available at http://www.fraserhealth.ca/about-us/accountability/report-
cards/report-cards .
Strategic Direction and Context
Strategic Direction
In February 2014, the Ministry released Setting Priorities for the B.C. Health System that identified
goals, priorities and enabling strategies for the health system. The Ministry also framed efforts to
improve health care in terms of the triple aim (Institute for Health Improvement) of improving the
health of populations, improving the patient and provider experience of care and reducing the per
capita cost of health by focusing on quality and the efficiency of care delivery.
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2015/16 Annual Service Plan Report 8
In May 2015, Fraser Health received clearly identified strategic directions and key performance
expectations in the 2015-16 Health Authority Mandate Letter. The specific strategic priority directions
(available in Appendix C) align with the 2014 Setting Priorities for the Health Care System, and are
informed by the Ministry of Health Policy Papers and Fraser Health annual budget allocation.
These priorities and the Taxpayer Accountability Principles address efficiency, accountability,
appropriate compensation, service, respect and integrity. The principles are built into Fraser Health’s
ongoing business to ensure decisions made reflect the priorities and values of government and their
shareholders – the citizens of B.C.
Strategic Context
Although the B.C. health system effectively meets the majority of the population health needs, it
continues to be challenged by an increasing demand for health services. The most significant drivers
of rising demand are the aging population, the increasing need to provide care to frail seniors, a rising
burden of illness from chronic diseases, mental illness and cancer and advances in technology and
pharmaceuticals driving new costly procedures and treatments. The pressure is compounded by the
need for new care delivery models by health professionals and health care workers, and the need to
maintain and improve the health system’s physical infrastructure (i.e. buildings, equipment and
information technology). The health system is a complex network of interdisciplinary teams of skilled
professionals, organizations and groups that work together to provide value for patients, the public
and taxpayers. The key challenge is to deliver a high-performing sustainable health system (from
prevention to end-of-life care) in the context of significant growth in demand.
Fraser Health has made meaningful progress in improving services across a range of areas over the
past several years, however some service areas continue to fall short of targets and require significant
effort in collaboration with the Ministry and other system partners to identify and implement
sustainable solutions. These areas include access to family physicians and primary care in many
communities, providing access to child and youth mental health services and effectively treating some
adult patients with moderate to severe mental illnesses and/or addictions, proactively responding to
the needs of the frail elderly who may require complex medical supports and assistance with activities
of daily living in order to remain living in the community, emergency department congestion in some
large hospitals, long wait times for some specialists, diagnostic imaging, and elective surgeries, stress
on access to inpatient beds in some hospitals and responding to the changing needs of patients in
residential care in terms of dementia.
To address these challenges and risks, Fraser Health undertook strategic shifts in 2015/16 including:
An IQCC (Improving Quality and Capacity for Care) plan that was designed and implemented
to improve hospital effectiveness and transition care to less expensive community based
services.
A leadership restructure that commenced in winter 2015 with the welcoming of a new CEO
continued through spring and summer with increased accountability as a guiding principle.
Newly appointed or reappointed leaders took up their duties with expectations for increased
site-based accountability established and reinforced. Decision-making at local levels with
consideration to local needs was increased.
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2015/16 Annual Service Plan Report 9
Report on Performance
The Ministry of Health Mandate Letter directs Fraser Health to ensure value for taxpayers while
providing responsive and effective health services.
Fraser Health enjoys a productive working relationship with the Ministry of Health, and routinely
engages with Ministry staff to ensure government direction on strategic and operational priorities is
aligned and supported. This collaborative approach is consistent with the requirements of the
Taxpayer Accountability Principles, and enabled Fraser Health to make significant progress against a
number of 2015/16 action items including:
Strengthened budget management at site and community levels;
Enhanced report cards and productivity reports at the hospital site level;
Establishment and implementation of policy outlining accountabilities, responsibilities and
budget variance protocols including escalation to the Board;
Implementation of a strong process to control and monitor staff hiring;
Keeping the Board Governance and Human Resource Committee well apprised of executive
and excluded compensation requirements, issues and impacts;
Evolution and enforcement of a new Standards of Conduct Policy covering Board to front-line
level decisions and activities;
Communicate effectively and timely ensuring all stakeholders are properly informed or
consulted on actions, decisions and public communications
Increased transparency and establishment of a strong ethical code of conduct in accordance
with the taxpayer accountability principles.
Fraser Health implemented and incorporated the six identified Taxpayer Accountability Principles
into ongoing operations, organizational practices and procedures. A Taxpayer Accountability
Principles Evaluation Plan for 2015/16 was submitted to the Ministry and among the application
highlights of each of the principles are:
1. Cost Consciousness (efficiency) - cost management capabilities were strengthened and
a culture of cost-consciousness was fostered in part with the implementation of a new
budget management policy outlining accountabilities, responsibilities and mitigation
protocols.
2. Accountability - responsibilities were managed transparently and the Fraser Health-
wide and hospital-specific report cards were published regularly on the Fraser Health
website.
3. Appropriate Compensation - a rigorous, standardized approach to performance
management and compensation for individuals was set within the guidelines of the
health sector compensation plan.
4. Service - a clear focus on positive outcomes for citizens of British Columbia was
maintained in increasing surgical volumes by 504 cases in summer 2015, and an
additional 1903 cases fall 2015 to spring 2016.
5. Respect - equitable, compassionate, respectful and effective communications along
with a spirit of partnership were demonstrated in the Use the ER Wisely pilot project
which is an ongoing partnership between Fraser Health and the White Rock/South
Surrey Division of Family Practice that is aimed at diverting appropriate patients to
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2015/16 Annual Service Plan Report 10
more appropriate resources available in the community, raising awareness about
appropriate Emergency Department use and also helping the public understand their
options.
6. Integrity - decisions made and actions taken were transparent, ethical and free from
conflict of interest as demonstrated in the publicly posted CEO contract and expense
report.
Goals, Strategies, Measures and Targets
This Annual Service Plan Report reflects operational results compared to the goals, objectives,
strategies and performance measures established in Fraser Health 2015/16 Service Plan in support of
system wide goals, priorities and strategies of the Ministry of Health set out in Setting Priorities for
the B.C. Health System.
The Ministry of Health articulates three goals for the health system as follows:
1. Support the health and well-being of British Columbians.
2. Deliver a system of responsive and effective health care services across
British Columbia.
3. Ensure value for money.
Underlying these goals and objectives is the principle of patient and family centered care: a sustained
focus on shifting the culture of health care in B.C. to put patients at the center, which will drive
policy, accountability, service design and delivery in the coming years.
Goal 1: Support the health and wellbeing of British
Columbians.
People living in British Columbia and in Fraser Health are among the healthiest people in the world.
Providing choices and creating supportive environments for positive health outcomes at the
individual, community and population levels will help keep this excellent health status. Helping those
who face greater barriers to health to have an equal chance at better health will further improve the
overall health status and thereby reduce health system demand. In collaboration with the Ministry of
Health and its government and non-governmental partners and through policies, programs and
decisions Fraser Health will prevent disease, protect health and promote wellness, and, sustain
changes to improve health of populations within its geographic service areas.
Objective 1.1: Implement targeted and effective primary prevention and health
promotion
Chronic disease is the largest cause of death and disability, represents the largest proportion of the
burden of disease and drives a significant part of downstream health costs. Evidence suggests that
over time, a primary prevention and health promotion agenda can make progress in improving the
overall health of the population, preventing or delaying the onset of chronic conditions and improving
the overall quality of life.
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2015/16 Annual Service Plan Report 11
Strategies
● Work in partnership with the Ministry of Health and other partners to continue implementation of
Promote, Protect, Prevent: Our Health Begins Here. B.C.’s Guiding Framework for Public
Health, the provincial framework for supporting the overall health and well-being of British
Columbians and a sustainable public health system.
● Work in partnership with the Ministry of Health and community partners to build and deliver on
Healthy Families B.C. Policy Framework.
● In partnership with the Ministry of Health and other partners, implement key health plans (e.g.,
provincial chronic disease and injury prevention plan, Healthy Minds, Healthy People) and
targeted plans for those who may experience greater barriers to good health (e.g., Aboriginal
Peoples, homeless, seniors) with a focus on evidence-based programs, services and interventions
to address major risk and protective factors across the life cycle.
Performance Measure 1: Healthy Communities
Performance Measure 2011/12 Baseline
2015/16 Target
2015/16 Actual
2016/17 Target
2017/18 Target
Percent of communities that have completed healthy living strategic plans
40%
60%
80%
EXCEEDED
65%
75%
Discussion
This performance measure focuses on 20 communities in Fraser Health (a proportion of the 161
communities of British Columbia) that have developed and are implementing joint healthy living
strategic plans, in partnership with Fraser Health and the Ministry of Health. Community efforts to
support healthy living through joint planning, policies, built environments and collaborative action are
critical to engaging individuals where they live, work, and play. Sustained community level actions
will encourage more active lifestyles while decreasing the risk factors for chronic diseases and injury.
Fraser Health exceeded its 2015/16 target for this measure with 80% of communities having a
completed healthy living strategic plan, and will continue to build upon successes achieved to date in
order to continue supporting and promoting the health and well-being of its populations.
Goal 2: Deliver a system of responsive and effective health
care services across British Columbia.
Fraser Health is committed to providing the best possible quality of care and service, which means the
care people receive responds to their needs and will lead to the best health outcomes. Fraser Health
must proactively address the increasing needs of the population due to aging, a rising burden of illness
from chronic disease and an increased prevalence of frailty by providing integrated care in the
community. Fraser is working actively with the Ministry and partners aiming to shift the culture of
health care from being disease-centered and provider-focused to being patient-centered. This shift
Data Source: Survey, Healthy Living Branch, Population and Public Health Division, Ministry of Health.
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2015/16 Annual Service Plan Report 12
requires understanding of and responsiveness to patient needs, values and preferences as the primary
drivers of daily practice at all levels, in a respectful and accountable manner in alignment with the
Taxpayer Accountability Principles. Managing care in the community effectively will reduce demand
on emergency departments, acute care hospitals and residential care. Innovation in care processes,
roles, policies and practices will be key to significant continuous improvement.
Objective 2.1: Strengthen commitments to patient centered care
In order to deliver more responsive and effective health care services, Fraser Health needs to become
a more patient and family-centered organization. This requires leadership and a commitment to
change the organization’s culture to view patients and families as equal members of the care team
with the right to participate in decisions affecting the planning, delivery and evaluation of care. Fraser
Health describes patient-centered care as “the patient and family is at the heart of every decision:
empowered to be equal partners in their care, valuing their needs, preferences and cultural beliefs”.
Every patient will be treated with respect, care, trust and dignity, has access to information, participate
in their care and collaborate as a true member of the health care team.
Fraser Health is striving to embed patient-centered care into its health service delivery systems. Board
and executive management decisions are focused on improving the patient experience and achieving
improved population and patient outcomes. Over the coming three years, the board will ensure that it
systematically examines the patient experience when redesigning services and that it promotes shared
values around creating a quality patient experience through recognition, respect, empathy, compassion
and dignity.
Strategies
● Identify and implement ways to incorporate patients into all Fraser Health work including Patient
Advisory groups to draw their insights and advice into continuous improvement efforts throughout
the system.
● Partner with Provincial Health Services Authority to develop a framework to create culturally safe
environments building on existing work within Fraser Health.
● Strengthen Fraser Health methods and processes for gathering insights about care experiences
through real time surveys, interviews and patient focus groups.
● Improve Fraser Health responses to concerns by patients about their care through appropriately
translated materials.
● Increase information flow and personal access to health data to empower patients to be full
partners in actively managing their health concerns.
Objective 2.2: Strengthen the system of primary and community care built
around interprofessional teams, processes and functions to
better prevent and manage chronic conditions.
The roles of family physicians, primary and community care professionals and support staff are
central to the effort of supporting patients suffering from frailty, chronic diseases, mental health and
substance use conditions. Focuses on effective team-based practices and establish healthy partnerships
between care providers and health care administrators to facilitate better care for the population,
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2015/16 Annual Service Plan Report 13
particularly those who are more vulnerable, with a key objective of reducing preventable
hospitalization.
Strategies
● Work in partnership with the Divisions of Family Practice to implement a system of inter-
professional health teams at the community level, improving access to primary health care with a
strong focus on populations and individuals with high health and support needs: people with
chronic diseases, mental illnesses and substance use, people with significant disabilities and the
frail senior population.
● Work in partnership with the Ministry to continue implementing the Provincial End-of-Life Care
Action Plan, including the availability of hospice spaces. Provide end-of-life care services
including hospice space expansion, home based palliative car, and clinical guidelines to support
those at the end of life with greater choice and access to service.
● Rebalance and maximize acute and community Mental Health and Substance Use capacity
through key investments such as increasing assertive outreach capacity for high users of acute care
and early intervention and crisis response services for youth and young adults. New services are
being developed as well, and include partnering with a non-profit provider on an intensive case
management team for individuals with a substance dependence issue and utilizing a ‘Housing
First’ approach. As well, a Child and Adolescent Stabilization Unit is being developed and will
become a regional resource in 2017. Access to addictions treatment will be improved through the
creation of additional 30 addictions spaces by 2017.
● Focus on developing and implementing chronic disease management and prevention strategies.
● Develop opportunities such as polypharmacy in residential care, where pharmacists and
physicians work together to achieve the optimal use of drugs for best patient outcomes.
● Increase the quality of primary and community care services including programs such as Home
First and BreatheWell which reduce the need for hospitalization.
● With the advice of British Columbia’s Seniors Advocate, improve the home and community care
system, better address the needs of British Columbia’s seniors who require these services, and
strengthen protections from abuse and neglect.
● Work with rural communities, including First Nations, to implement a renewed approach to
providing quality health services across rural and remote areas.
Performance Measure 2: Managing Chronic Disease in the Community
Performance Measure 2013/14
Baseline
2015/16 Target
2015/16 Actual
2016/17
Target
2017/18
Target
Number of people with select chronic diseases admitted to hospital per 100,000 people aged 75 years and older (age-standardized)
3,388
3,352
3,400
3,189
3,026
Data Source: Discharge Abstract Database, Business Analytics Strategies and Operations Branch, Health Sector Information, Analysis and Reporting
Division, Ministry of Health. Note: Annualized Quarterly Data
Discussion
This performance measure tracks the number of people, 75 years of age and older, with select chronic
diseases such as asthma, chronic obstructive pulmonary disease, heart disease and diabetes, who are
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2015/16 Annual Service Plan Report 14
admitted to hospital. People with these chronic diseases need the expertise and support of health care
providers to help manage their disease in the community in order to remain as healthy as possible and
reduce complications that require more medical care. This proactive disease management reduces
unnecessary emergency department visits, hospitalizations and diagnostic testing. As part of a larger
initiative of strengthening community based health care and support services, health care
professionals are working to provide more appropriate care in the community and at home in order to
help seniors with chronic diseases to remain as healthy as possible.
With a rate of 3,400 people with select chronic diseases admitted to hospital per 100,000 people aged
75 years and older (age standardized), Fraser Health was slightly over the target, but improved over
last fiscal year performance of 3,449. Factors contributing to the challenge include Fraser Health’s
population experiencing a higher rate of many chronic diseases than other health authorities with
rapid demographic shifts, growing resource constraints, gaps in community based services for chronic
disease management and patient difficulties in navigating the services.
Work to improve management of chronic diseases is well underway across services and the care
continuum. This includes enhancing community based services, improving discharge planning and
post-acute follow up, and adding supports to avoid unnecessary hospital admissions. In addition and
in partnership with Fraser Health, Divisions of Family Practice are concentrating focus on supporting
the chronic condition population by advocating for navigators, health education and counselling.
Performance Measure 3: Community Mental Health Services
Performance Measure 2013/14
Baseline
2015/16 Target
2015/16 Actual
2016/17
Target
2017/18
Target
Percent of people admitted to hospital for mental illness and substance use who are readmitted within 30 days (15 years of age and over)
12.7%
12.6%
13.2%
12.4%
12.0%
Data Source: Discharge Abstract Database, Business Analytics Strategies and Operations Branch, Health Sector Information, Analysis and Reporting Division, Ministry of Health.
.
Discussion
With the release of Healthy Minds, Healthy People, a clear vision was established for addressing the
complexities of mental illness and substance use. A number of interventions have been incorporated
as part of British Columbia’s health system which have successfully responded to individual patient
needs.This performance measure focuses on one aspect of the effectiveness of community-based
supports to help persons with mental illness and/or substance use issues receive appropriate and
accessible care, and avoid readmission to hospital. Other components include good discharge
planning and maintaining the appropriate length of stay in a hospital. Central to these efforts is
building a strong system of primary and community care which enhances capacity and provides
evidence-based approaches to care.
With 13.2% of people admitted to hospital for mental illness and substance use who are readmitted
within 30 days (15 years of age and over) in 2015/16, Fraser Health fell short of the target. Factors
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2015/16 Annual Service Plan Report 15
contributing to the challenge include an increasing prevalence of mental illness and substance use
with a rapidly growing and aging population, complex clients with dual diagnosis, together with other
individuals who are severely addicted and mentally ill (SAMI), people with complex co-occuring
disorders and homeless or risk of homelessness.
Fraser Health is committed to improving patient health outcomes and reducing hospitalizations for
those with moderate to complex mental health and/or substance use issues through an effective and
integrated continuum of care. By the end of 2018 Fraser Health’s mental health and substance use
program will provide specialized care programs (SCPs) in each of 13 Fraser Health geographic
service areas linked to primary care homes. The SCPs will provide specialized mental health and
substance use services through inter-professional teams and contracted service providers to improve
patient/clients health outcomes and care experience, and to reduce hospital use for patients with
moderate to complex mental health issues, substance use issues, and co-occurring conditions.
Objective 2.3: Renew the role of hospital in the regional health care continuum
with a starting focus on improved surgical services.
Acute care is the largest and most expensive sector in the health care system. Within this sector, the
use of hospitals is changing. Advances in technology and techniques have led to less use of inpatient
beds for surgical recovery as outpatient day surgery has increased. A majority of the inpatient bed
capacity in many hospitals is now used for Fraser Health’s growing population of frail seniors, and
Fraser Health must ensure those services are delivered appropriately for those patients. There is a need
and opportunity to better link the acute care system to the regional and community systems, improve
provincial coordination and ultimately improve the quality of acute care services delivered to patients
in British Columbia.
Strategies
Achieve significant improvement in timely access to appropriate surgical procedures through
increasing volumes of cases prioritized based on patient need and through efficiencies in processes
and systems.
Reduce the actual length of stay in Fraser Health hospitals to the expected length of stay as
calculated by the Canadian Institute for Health Information.
Improve access and reduce wait times for scheduled surgery, CT and MRI, and admission to an
inpatient bed from the emergency department.
Improve the link between hospitals, primary care and other care providers in communities.
Explore opportunities to use hospitals more effectively, including shifting to community based
delivery of services where appropriate and using outpatient clinics.
Implement strategies and best practices to improve patient flow starting with reducing demand in
emergency departments, transitions through the acute care sector and transitions into the
community.
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Performance Measure 4: Access to Scheduled (Non-Emergency) Surgery
Performance Measure 2013/14 Baseline
2015/16 Target
2015/16 Actual
2016/17 Target
2017/18 Target
Percent of scheduled surgeries completed within 26 weeks 89%
93%
85%
95%
95%
Data Source: Surgical Wait Time Production (SWTP, Site 147), , Ministry of Health. Includes all elective adult and pediatric surgeries.
Notes: 1. Baseline is for surgeries completed from April 1, 2013 to March 31, 2014. Target percents are for surgeries completed in the fiscal year.
2. The total wait time is the difference between the date the booking form is received at the hospital and the date the surgery is completed.
Discussion
During the last several years, there has been a focus on reducing wait times for many surgeries.
Funding incentives, combined with continuous efforts to foster innovation and efficiency in British
Columbia’s hospitals, are initiatives designed to improve the timeliness of access to an expanding
range of surgical procedures. B.C. currently has five priority levels, each with its own wait time
target, that provides a benchmark for the time which patients with that priority level should wait for
their surgery. This performance measure tracks whether scheduled surgeries are completed within the
maximum established benchmark wait time of 26 weeks. Surgical resources are also being allocated
to complete the surgeries of people who have been waiting the longest.
With 85% of non-emergency surgeries completed within 26 weeks in 2015/16, Fraser Health fell short
of the target. Factors contributing to the challenge included capped capacity, shortages of anesthetists
and nurses, and competing focus on two other important imperatives: ensuring patients needing hip
fracture surgery get it within 48 hours, and eliminating patients waits of more than 52 weeks for
surgery.
Within the provincial context of scheduled surgery improvements additional 2016/17 investment in
surgery in Fraser Health is focused on increasing efficiency, increasing capacity, reducing wait times,
identifying opportunities for optimization and resolving system gaps.
Objective 2.4: Increase access to an appropriate continuum of residential care
services.
The populations requiring residential and assisted living care have varied health and social care needs.
These include dementia, cognitive behavioural disorders, acquired brain injury and multiple chronic
conditions requiring long term respiratory and/or nutritional supports. The complexity of care has
increased appropriately shifting long term and stable conditions to a residential setting outside of
hospitals. A key priority of the health care system is to work with partners to ensure a mix of services
that best meet the needs of frail senior and other patients.
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2015/16 Annual Service Plan Report 17
Strategies
● Work in partnership with the Ministry to develop and implement residential care models and
quality standards for patients with dementia and younger populations with special needs such
as chronic severe mental illness.
● Work in partnership with the Ministry to expand home support and technology for home
health monitoring services to help seniors stay at home longer.
● Develop plans to increase capacity for specialized populations such as the medically complex
and peritoneal dialysis.
● Incrementally increase access to residential care and specialty residential beds per 1,000
population 75+ rate over the coming three years in order to improve access to care and to meet
the provincial guideline of 75 beds per 1000.
Goal 3: Ensure value for money.
To ensure value for money in the health system Fraser Health must ensure health system resources are
used in the most efficient and effective way possible. On a strategic level, this includes not only what
services and initiatives are focused on, but also how they are implemented and managed. In the
coming years, Fraser Health, the Ministry and other health organizations will collaborate on the
effective implementation and management of a shared, consistent strategic plan for the health system
with built-in accountability and attention to factors needed for success: change management capacity,
ongoing quality improvement, effective leadership and an engaged workforce, information
management systems and technologies, physical infrastructure and prudent budget management.
Objective 3.1: Drive continuous improvement with performance management and
an accountability framework.
An efficiently managed health system ensures resources are spent where they will have the best health
outcome. A focus on budget management and efficiency, along with collaboration and quality
improvement must be continually pursued in partnership with other health authorities and
stakeholders to ensure our publicly funded health system is effective and affordable for the citizens of
British Columbia.
Strategies
● Continue to drive clinical quality improvement throughout the health system, particularly in the
areas of: o Primary and community care o Surgical services
● Drive quality, cost-effectiveness and coordinate investments in new laboratory technology through
the provincial laboratory reform initiative.
● Engage in collaborative planning with other Lower Mainland health authorities on select clinical
services to achieve improved quality and patient outcomes, and continue consolidation of
corporate, clinical support, purchasing and administrative functions to achieve savings and quality
improvements across the province.
● Continue to develop performance monitoring tools, management and reporting practices to assist
Fraser Health Authority
2015/16 Annual Service Plan Report 18
clinical and management decision making and optimize health expenditures.
Performance Measure 5: Nursing Overtime
Performance Measure 2010
Baseline
2015 Target
2015
Actual
2016
Target
2017
Target
Nursing overtime hours as a percent of productive nursing hours
3.9%
<= 3.3%
4.0%
<= 3.3%
<= 3.3%
Data Source: Health Sector Compensation Information System, Health Employers Association of British Columbia.
Note: Based on calendar year.
Discussion
This performance measure compares the amount of overtime worked by nurses to the overall amount
of time nurses worked. Overtime is a key indicator of the overall health of a workplace as high rates
of overtime may reflect inadequate staffing or high levels of absenteeism. Reducing overtime rates by
addressing the underlying causes helps promote both patient and caregiver safety while also reducing
unnecessary costs to the health system.
At 4.0% Fraser Health’s nursing overtime hours as a percent of the productive nursing hours fell short
of the target for 2015/16. Factors contributing to the challenge include patient flow and bed allocation
initiatives, difficulties recruiting and retaining specialty trained nurses and the geographical location
of certain sites relative to the potential labour pool.
Fraser Health has comprehensive overtime management best practice and mitigation strategies in
place including guidelines and interpretation tools, recruitment tools and overtime and recruitment
accountability frameworks.
Objective 3.2: Align cross-system and collaborate on health human resources,
IMIT and technology infrastructure, and funding approaches to
achieve patient and service outcomes.
A high performing health system is one that uses its resources in the best way possible to improve
health outcomes for patients. Ensuring the health system has sufficient numbers and the right mix of
health professionals is key to providing the services that will meet British Columbians’ needs now and
in the future. Health care providers must also be appropriately supported by leadership, information
management systems, technologies and the physical infrastructure to deliver high quality services as
efficiently as possible.
Strategies
● Work in partnership with the Ministry of Health to develop and implement an integrated
provincial workforce strategy to ensure B.C. has the required supply of health care providers,
Fraser Health Authority
2015/16 Annual Service Plan Report 19
their skills are being used effectively and the health care workforce is engaged, skilled, healthy
and well managed.
● Continue to modernize the health system through the use of information management and
technology, including electronic medical records, clinical decision support tools, electronic
medication reconciliation, telehealth and home health monitoring.
● Continue to support health information exchange and integrate clinical information systems
across the entire continuum of care.
● Review funding models, strengthen cost management systems and build reporting capacity to
ensure effective management of funds to achieve patient and service outcomes.
● Continue building Fraser Health’s business analytics capabilities to support population health
strategies, organizational performance and quality improvement.
Objective 3.3: Evidence-informed access to clinically effective and cost-
effective pharmaceuticals.
Pharmaceuticals play an important role in B.C.’s health care system. They treat and prevent the spread
of disease; control pain and can improve quality of life for many people. A continued focus on
ensuring timely and evidence-informed access to pharmaceuticals that are safe, therapeutically
beneficial and cost-effective will improve both patient care and value for money in the health system.
Strategies
● In partnership with Lower Mainland health authorities and with the Ministry, deliver an
accessible, responsive, evidence-informed, sustainable pharmaceutical management and
delivery program.
● Seek opportunities for pharmacists and physicians to work together to improve the optimal use
of drugs for best patient outcomes.
● Continue to implement strategies to ensure optimal drug safety throughout Lower Mainland
health authorities.
● Implement a Utilization Management Program to reduce the inappropriate and unnecessary
use of services and resources in all Fraser Health clinical and clinical support areas.
Fraser Health Authority
2015/16 Annual Service Plan Report 20
Financial Report
Discussion of Results
Fraser Health is committed to a balanced budget each year based on improving patient, resident and
client quality, safety, access and experience. For the 2015/16 fiscal year, Fraser Health ended with a
surplus of $0.4 million on a budget of $3,312.0 million (or 0.01% of budget). Further, Fraser Health’s
external auditors issued an unqualified audit opinion on the issued financial statements. The budget
disclosed is the budget in the Fraser Health Authority 2015/16-2017/18 Service Plan (June 2015).
In order to achieve a balanced budget, Fraser Health has a policy outlining accountabilities,
responsibilities and variance control protocols along with variance follow-up protocols that include
involvement of the Board’s Finance and Audit Committee.
Revenues for the fiscal year totaled $3,368.1 million of which $3,216.8 million, or 96%, were grant
contributions and other recoveries from the Ministry, other health authorities and other provincial
ministries and agencies. The revenue from Provincial government sources was greater than budget as
a result of additional funding allocated subsequent to the budget approval for wage settlements,
additional surgical procedures and MRIs, Medical Service plan rate and volume increases, non-
resident revenues, and Lower Mainland Consolidation recoveries.
Acute care expenses exceeded budget as a result of wage settlements and the opening of capacity to
manage hospital congestion issues and higher than budgeted activity which are offset by funding
received subsequent to budget approval.
Corporate expenses exceeded budget due to adjustments to the Healthcare Benefit Trust (HBT) pool
in the prior year.
Fraser Health Authority
2015/16 Annual Service Plan Report 21
Financial Resource Summary Table
($ millions) 2015/16 2015/16
Variance Budget Actual
OPERATING SUMMARY
Provincial Government Sources
3,174.4
3,216.8 42.4
Non-Provincial Government Sources
137.6
151.3 13.7
Total Revenue:
3,312.0
3,368.1 56.0
Acute Care
1,925.9
1,963.1
(37.3)
HCC – Residential
560.2
553.6
6.6
HCC – Community
302.6
296.2
6.4
Mental Health & Substance Use
238.1
234.3
3.8
Population Health & Wellness
81.9
81.9
(0.0)
Corporate
203.4
238.6
(35.2)
Total Expenditures:
3,312.0
3,367.6
(55.6)
Surplus (Deficit) -
0.4 0.4
CAPITAL SUMMARY
Funded by Provincial Government
55.4
36.2
19.3
Funded by Foundations, Regional
Hospital Districts, and Other Non-
Government Sources
64.2
35.4
28.8
Total Capital Spending
119.6
71.5
48.1
Fraser Health Authority
2015/16 Annual Service Plan Report 22
Major Capital Projects
Capital investment ensures that Fraser Health’s infrastructure is maintained and expanded to meet the
health services needs for a growing population. Capital investment includes facilities such as
hospitals and residential and complex care buildings, medical equipment such as CT scanners, MRI’s
and surgical equipment and information technology and information management systems.
Fraser Health’s capital budget is conceived based on the prioritized needs of the health authority, the
availability of funding and the priorities of government. Given the long lifespan of most capital
investments, a three year capital expenditure plan is maintained.
Major capital projects currently underway or in planning are listed in the table below:
Major Capital Projects Targeted
Completion
Date (Year)
Approved
Anticipated
Total
Capital Cost
of Project ($
millions)
Project Cost
to March 31,
2016 ($
millions)
Chilliwack General Hospital Chiller & Cooling Tower - install a
new chiller and cooling tower that focuses on energy efficiency and
redundancy. The existing chillers are 26 years old and at the end of
their useful life.
2016/17 2.000 0.842
Delta Hospital Diagnostic Imaging & Lab Expansion - build a
new 2 level addition on the south west side of the hospital to
accommodate a new Medical Imaging space and Laboratory. These
renovations will improve infection control, patient confidentiality
and flow, the work environment and safety issues.
2018/19 12.500 0.200
Langley Memorial Hospital Electrical Upgrade Phase 2 - current
age and capacity of the system does not support future infrastructure
growth of the campus. The scope of Phase 2 includes a 1200kW
generator, a new switchgear, two high voltage transformers, new
auto-paralleling system for both new generators and closed-transition
automatic transfers, redirecting power supply to the new energy
centre and back-feed power supply to the hospital.
2017/18 4.95 2.572
Langley Memorial Hospital South Tower Exterior Seismic
Upgrade - the South Tower was identified as having a high seismic
risk involving life safety. An assessment recommended upgrading
the structure to mitigate the risk.
2017/18 3.000 -
Peace Arch Hospital Electrical Upgrade - Replace South Tower
electrical distribution system which is outdated, past life expectancy
and generally in poor condition. Specifically, replace the 500 kW
diesel generator with a new 800 kW generator and replace the
existing generator paralleling switchgear and controls with a new
arrangement employing active paralleling system.
2016/17 6.585 6.369
Fraser Health Authority
2015/16 Annual Service Plan Report 23
Peace Arch Hospital Russell Building Replacement - Existing
Russell Building (Mental Health Outpatient) will be demolished to
make room for construction of a new generator building as part of
the Electrical Upgrade. This project will renovate a trailer moved
from Surrey Memorial Hospital site to replace the existing building.
2016/17 2.375 2.349
Royal Columbian Hospital Emergency Mental Health Substance
Use Space - Renovations to develop MHSU (Mental Health
Substance Use) space that is more clinically appropriate. The current
emergency department MH space is grossly inadequate with minimal
opportunity for privacy or confidentiality. MHSU space will provide
increased capacity and improved patient safety.
2015/16 2.000 2.000
Royal Columbian Hospital Emergency Trauma Room -
Renovations within the ER to add a 4th Trauma Room and negative
pressure rooms. Current limited access to trauma bays creates a
situation where it may take several hours to move a patient from the
ER to an inpatient unit. ER has only one isolation room which is not
up to current standards. Renovations will create enhanced trauma
capacity for RCH to fulfill its trauma and referral role In FH with
improved patient care, particularly during times of congestion.
Additional isolation capacity will improve patient safety and
infection control.
2016/17 3.082 3.077
Royal Columbian Hospital Redevelopment Phase 1 - this phase
includes a 75 bed mental health and substance use facility (45 net
new beds), new energy centre, new parking and replacement of
existing stalls, relocation of the heliport, demolition of the
Sherbrooke building, and the development of an integrated IM/IT
infrastructure.
2019/20 248.569 1.968
Royal Columbian Hospital Pharmacy Renovation - redevelop the
current workspace and renovate (110 square meters) an across the
hall space to provide an effective and efficient process flow, which
will address a number of issues including the management and
storage of inventory, manufacturing and prepackaging of product,
professional education resources space, and pharmacy administrative
area. In addition, this project includes the equipment and renovations
needed to improve pharmacy functionality through the
implementation of automated dispensing units.
2016/17 2.570 1.159
Royal Columbian Hospital Automated Drug Distribution - this
project will implement ADCs (automated dispensing cabinets) and
related technologies, systems, business processes and clinical
practice changes at RCH to support improvements in medication
safety and inventory management, along with the required
renovations to clinical areas to support ADC implementation.
Medication Order Management (MOM) software will be installed to
automate communication between nursing and pharmacy, improving
efficiencies for both departments.
2017/18 6.800 2.947
Fraser Health Authority
2015/16 Annual Service Plan Report 24
Royal Columbian Hospital Cardiac Catheterization Labs
Equipment Replacement - replace fluoroscopy and hemodynamic
equipment in the RCH cardiac cath laboratories which is nearing end
of life timeline. It is vital to the continued quality and safety of
patient care. RCH is the only Fraser Health site that offers diagnostic
and interventional cardiac procedures and needs to be fully
functional at all times.
2017/18 3.300 0.009
Surrey Memorial Hospital Critical Care Tower and Expansion
Project – the emergency department opened in October 2013 and the
tower opened in June 2014. The expansion at SMH also includes
now completed renovations to the existing hospital which added
inpatient beds, created an expanded family birthing unit, and
upgraded and enlarged the pharmacy and sterile processing unit.
2018/19 486.376 463.554
Surrey Memorial Hospital Integrated OR - replace non-functional
equipment within SMH OR's, specifically teleconferencing
equipment, integration equipment, surgical video equipment and
other medical devices & equipment.
2016/17 4.250 0.996
Surrey Memorial Hospital Child & Adolescent Stabilization Unit - CAPSU is a 24 hour, 7 day a week inpatient unit that provides short
stay care for children and youth ages 6 to 16 who are experiencing
acute psychiatric problems. The CAPSU will have a short length of
stay with an average of 5 to 7 days. Currently these patients are
being admitted to Emergency Departments, pediatrics or adult
psychiatric units.
2016/17 4.020 0.087
Surrey Memorial Hospital Code Compliance Sprinkler Upgrade
- upgrade of sprinkler system to meet code requirements (building B
& F are only partially sprinklered). Rectify other Priority 1
deficiencies that have a high impact to the fire and life safety for our
patients/staff/clients. As a condition to the approval of the
Redevelopment permits, FHA made a commitment to the City of
Surrey to resolve these significant deficiencies. This upgrade will
greatly improve the safety of everyone within the hospital.
2016/17 3.400 1.697
Surrey Memorial Hospital Electrical Distribution Upgrade Bldgs
A,B,F - update the current system of feeders so that buildings A, B
& F receive their respective power directly from the Energy Centre
which has been upgraded to provide adequate site wide emergency
power with a new distribution switchgear to facilitate connections.
Building A, B & F are currently provided with electrical power from
an interconnecting network of 600V and 208 V feeders. This
network is complicated and does not adhere to the newest codes.
2017/18 2.000 -
Fraser Health Authority
2015/16 Annual Service Plan Report 25
Information Management: Advanced Clinicals Patient Care
System - Patient Care System (PCS) is an advanced software
products in the Meditech application suite fully integrated with the
Meditech Clinical Information System, which is used across all of
the acute care facilities in Fraser Health. PCS it will enhance three
key areas of functional capability, which will contribute to improved
interdisciplinary care planning: Assessments, Care
Plans/Paths/Mapping, and Clinical documentation. PCS will
ultimately serve as the enabling platform for other advanced clinical
applications, including electronic Medication Record (eMAR) and
Bedside Medication Verification (BMV).
2016/17 2.392 1.056
Information Management: Advanced Clinicals Physician Care
Manager Phase 1 - Physician Care Manager (PCM) is an advanced
software products in the Meditech application suite fully integrated
with the Meditech Clinical Information System, which is used across
all of the acute care facilities in Fraser Health. PCM will ultimately
serve as the enabling platform for a number of advanced clinical
applications, including electronic physician documentation and
Computerized Physician Order Entry. Phase 1 of the project
involves the deployment of Physician Desktop which provides a
single access point to the information and functional capabilities that
physicians need about their patients, Implement electronic signature,
wireless mobile computing devices, and wireless functional
capability so data can be accessed whenever and wherever needed.
Prerequisite PCM infrastructure, including hardware for servers and
storage will also be acquired.
2016/17 3.623 3.274
Information Management: PARIS Phase 3 - PARIS (Primary
Access Regional Information System) is the core clinical information
system used by Home and Community Care (HCC) and Mental
Health Substance Use (MHSU) at Fraser Health Authority (FHA).
PARIS is currently hosted on end of life (EOL), legacy infrastructure
(Windows Server 2003) at the Jim Patterson North, 3rd Floor (JPN3)
data centre. FHA has identified the need to upgrade to the most
recent version of PARIS (v6.0.10), move to a supported operating
system version, and implement a disaster recovery (DR) strategy.
2017/18 2.185 0.054
Information Management: Large Volume Infusion Pumps
Wireless Access - provide safe patient care through the use of Smart
Pump Technology. Infusion pumps are devices that deliver specific
doses of fluids, including blood, nutrients and medications, into a
patient's body in a controlled manner. Wireless capability is required
to allow pumps to update Drug Library and download CQI data
wirelessly. Due to limited funding, this project will only provide 1 -
2 hotspots per clinical area.
2016/17 2.555 2.027
Information Management: PharmaNet Interface to MedRec
Solution - this project will support the Medication Reconciliation
initiative in Fraser Health by improving the access to and
consumption of data from PharmaNet. PharmaNet is the province-
wide network that links all B.C. pharmacies to a central set of data
systems.
2017/18 3.081 -
Fraser Health Authority
2015/16 Annual Service Plan Report 26
Information Management: Integrated Plan of Care - Abbotsford
Regional Hospital & Cancer Centre - this project will implement
MEDITECH Patient Care Systems to electronically support
integrated plans of care enabling clinical data system integration,
standardizing health care workflow processes, and integrating
person-centered information in support of health care for Fraser
Health persons and providers.
2017/18 4.570 2.125
Information Management: Facilities Management Information
System - this project will provide a capital project management
solution which will upgrade and increase the capacity of the existing
system.
2016/17 2.616 1.065
Information Technology: Network Infrastructure 13/14 - the
purpose of this project is to remediate network issues and
infrastructure at Royal Columbian Hospital. The focus is on
replacing aging network core switches and upgrading network switch
power infrastructure located in the communication rooms.
2016/17 2.942 1.863
Information Technology: Network Infrastructure 14/15 - the
purpose of this project includes the assessment of network risks
across FHA sites. The focus of this project is on replacing aging
network core switches at ARH, CGH, BUH, and DH and upgrading
network switch power generation infrastructure located in the
communication rooms.
2016/17 2.100 1.391
Fraser Health Authority
2015/16 Annual Service Plan Report 27
Appendix A: Health Authority Contact Information
For more information about Fraser Health please visit:
http://www.fraserhealth.ca
Or, contact:
Fraser Health
Corporate Office
Suite 400 – Central City Tower
13450 – 102nd Avenue
Surrey, B.C. V3T 0H1
Telephone: 604-587-4600
Facsimile: 604-587-4666
Fraser Health Authority
2015/16 Annual Service Plan Report 28
Appendix B: Hyperlinks to Additional Information (optional)
For more information, please visit:
Fraser Health Authority 2015/16-2017/18 Service Plan
Fraser Health Authority 2014/15-2016/17 Service Plan
Fraser Health’s Board Accountabilities and Governance Practices
Fraser Health’s Our Health Care Report Card
Setting Priorities for the B.C. Health System
Healthy Families BC Policy Framework
Ministry of Health 2015/16 Annual Service Plan Report
Promote, Protect, Prevent: Our Health Begins Here. BC’s Guiding Framework for Public
Health
Fraser Health Authority
2015/16 Annual Service Plan Report 29
Appendix C: Health Authority Mandate and Actions Summary
In the 2015/16 Mandate Letter from the Minister of Health, Fraser Health Authority received direction
on strategic priorities for the 2015/16 fiscal year. These priorities and the health authority’s resulting
actions are summarized below:
Mandate Letter Direction Health authority Action
1. Deliver patient-centered services and
care to shift the culture of health care
from being disease-centred and
provider-focused to being patient-
centred.
Fraser Health is ensuring delivery of patient centered
services and care by demonstrating a conscious shift
of the culture from being disease centered and
provider focused to being patient centered.
Beginning with restructuring of the organization in
2014 that created a new position titled, VP Patient
Experience, rebalanced hospital and non-hospital
resources, and decentralized care management to
geographical service areas has created an
environment where patients, families and front line
health providers are working together as partners in
providing day-to-day care. By patient and family
engagement FH is meaning that patients and families
are being involved beyond their own care as
organizational partners/advisers e.g. monitoring and
integrating patient feedback to improve patient
experiences.
Fraser Health’s alignment with the Ministry
framework for patient and family centered care was
recognized by the provincial Patients as Partners
steering committee, as were partnerships with
community organizations like Impact BC with whom
engagement sessions with patients were held to learn
from patient experiences. Much point-of-care work
has been done by Fraser Health with front line care
providers at sites, for example Ridge Meadows
Hospital. Additionally, the FH Board and leadership
decisions have been focused on improving the
patient experience and achieving improved
population and patient outcomes.
2. Ensure the delivery of high quality
and appropriate health services that
best meets the assessed needs of your
population in a fiscally sustainable
manner.
Development of hospice space
expansion to meet Government’s
Fraser Health achieved budget targets, ending the
2015/16 fiscal year balanced. Factors contributing to
this achievement included realizing efficiencies in
utilization of hospitals/facilities through improved
care processes reducing unnecessary delays in
flow/discharges, shifting more care delivery into the
community resulting in a gradual increase in
Fraser Health Authority
2015/16 Annual Service Plan Report 30
Mandate Letter Direction Health authority Action
goal of doubling hospice spaces
in B.C. by 2020; and,
Full implementation of the
provincial mental health and
addictions plan, Healthy Minds,
Healthy People, including
expansion of addiction spaces by
2017.
utilization of primary and community care to support
patients who do not need to be in hospital. Fraser
Health continues to work on delivering high quality
and appropriate fiscally sustainable services that
meet the assessed needs of our populations. Specific
actions include:
Increase Hospice residence to achieve the
goal of doubling of hospice spaces by 2020.
Fraser Health finalized plans to establish
hospice residence in each community
increasing by 33 new hospice beds in the
Fraser Valley by 2016-19 i.e. 10 beds in
Abbotsford, 5 in Langley, 10 in New
Westminster and 8 in White Rock.
Continued implementation of Healthy Minds,
Healthy People: A Ten Year Plan to Address
Mental Health and Substance Use in British
Columbia achieving significant progress
accomplishing three of the six planned
milestones with two ahead of schedule, and
the remainder three to achieve as targeted.
Key accomplishments include:
- Improved access to the Early Psychosis
Intervention Program
- Established two new Assertive
Community Treatment (ACT) teams in
Surrey/N. Delta and Abbotsford/Mission
to provide comprehensive, community-
based mental health treatment,
rehabilitation and support with persons
with serious addictions and mental illness
(SAMI).
- Firmed plans for opening of the 10-bed
Child and Adolescent Psychiatric
Stabilization Unit (CAPSU) in 2016-17
- Improved care transitions across the
continuum of care by standardizing and
streamlining processes
- Expanding housing services to increase
capacity, through collaboration with
community partners
- Opened 8 new addiction beds by March
31, 2015 and an additional 38 beds in
2015/16.
Fraser Health Authority
2015/16 Annual Service Plan Report 31
Mandate Letter Direction Health authority Action
- Enhanced FH capacity to provide a
regional service START for children and
youth with a mental health crisis in the
community (prevents ED visit)
3. Manage the performance of your
organization through continuous
improvement across service and
operational accountabilities.
Fraser Health is building on successes achieved
through increasing community services that support
patients at home, and is focusing on delivering a
patient centered culture across all health care
services, while improving on the quality of service
outcomes. This is evidenced by the improvement of
Fraser Health KPI reported values which are being
closely monitored at all levels of cascading
leadership. See Our Health Care Report Card and its
supporting reports - changes in meeting target status
by hospital and hospital Key Performance Indicators
performance comparison.
4. Improve care for key patient
populations and service delivery in
cross sector priority areas that are
critical to both quality and
sustainability by:
Improving access and service
design for primary health care,
home and community care, and
residential care for those with
high health care and support
needs (e.g., complex chronic
conditions, frail elderly, and
moderate to severe mental illness
and/or substance use issues) in
order to reduce the flow of these
populations into hospital;
Achieving significant
improvement in timely access to
appropriate surgical treatments
and procedures; and,
Working with rural communities,
including First Nations, to
implement a renewed approach to
providing quality health services
across rural and remote areas.
Established foundational elements and developed
key strategies for the cross sector priority areas. We
are building community services to support patients
at home, while improving care processes in hospitals
to expedite steps that help people transition home
sooner. This has enabled the authority to:
Implement the Home First initiative, a
philosophical shift considering “Home is Best”
for many frail elderly patients who function well
in their own familiar surroundings.
Take community based actions to support
chronic disease management i.e. implement
BreatheWell services in some of the residential
and community services of New Westminster,
Burnaby, Langley, Chilliwack and Surrey’s
Gateway and Newton communities. Currently
being implemented FH wide.
Establish Hospital Operational Management
Committees (HOMC) at all 12 sites to support
clinical operations achieve improvements,
monitor and manage progress. Individual targets
have been developed for each hospital to keep
the health authority on track to deliver patient
centered care.
Commence Repositioning of Health Care for
Older Adults. Identified three prototype
communities for seniors redesign; laid
foundations to implement new models of care in
Fraser Health Authority
2015/16 Annual Service Plan Report 32
Mandate Letter Direction Health authority Action
the prototypes.
Develop individual care plans for frequent users
of emergency at test-bed sites. With the success
achieved at the test sites, FH is in the process of
revitalizing the initiative to scale and spread it
across the health authority.
Firm plans to improve hospital effectiveness
through decreasing unnecessary hospital
utilization (remove hallway and inappropriate
beds), and make staff changes to create more
standardized care in similar units; with,
implementation early 2016.
Invest $5M to sustain improvement initiatives
that would decrease the number of patients
waiting admissions by expanding targeted
positions in the emergency, enhancing weekend
discharges, increasing home health supports on
weekends and decreasing bed turnaround time in
residential care.
Opened 75 new residential beds. Sustaining
residential care capacity while creating new
capacity, example 24 new beds in Mission,
conversion of 12 beds to complex care in Surrey,
34 new beds in tri-cities with 12 existing beds
reallocated to care for medically complex
patients (long stay patients).
Consolidated multiple home health care intake
lines into one centralized call center to provide
user friendly access to community resources.
Focused work on increasing efficiency,
increasing capacity, reducing wait times,
identifying opportunities to optimize and resolve
system gaps. Evident by completing site action
planning allocating OR case volumes (RAM) to
support 40 week target.
Surgical program to uphold standards has
implemented multi-modal strategies to build
capacity, define and disseminate best practices
and engage teams. Clinical protocols and
dedicated time has been made more available for
certain surgeries to reduce barriers to surgery e.g.
hip fractures. Care is being focused on quality
pain management, enhanced nutrition and early
mobility.
Enhancing site waitlist management practices
Fraser Health Authority
2015/16 Annual Service Plan Report 33
Mandate Letter Direction Health authority Action
Working closely with the First Nations Health
Authority and regional partnership tables for
input into the Fraser Health service planning and
delivery activities.
Commenced targeted work in the communities of
Chilliwack, Fraser Canyon, Mission to improve
the health of the remote and First Nation
populations through advocacy, partnership
building & shared decisions to provide culturally
safe and effective services.